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Welcome to this 3-contact-hour Continuing Education  course with instant online processing and certification 24/7.  Study the course below, take the 12-question multiple-choice TEST, register and pay online. If you score 75% or above, you may print your CE certificate on your printer as soon as you finish. If you have difficulty printing your certificate, click here. You may retake the test once.

1. Fitness Facts

1.1 Musculo-Skeletal and Cardio-vascular Systems

"Take It Easy You're Not as Young as You Used to Be" is not so sage advice. Yet, the majority of middle-aged and older Americans seem to adhere to this outmoded dictate. Surveys show that only 30 percent of Americans aged 45 to 64 exercise regularly, while 32 percent of adults 65 and older follow a regular plan of exercise.

We now know that the human body repairs itself and performs more efficiently with proper conditioning that is achieved through a program of regular exercise and good nutrition. This is particularly true for the musclo-skeletal system and the cardio-vascular-pulmonary system, which is made up of our lungs, heart, and the miles of veins, arteries and capillaries that traverse our bodies.

With exercise, our bones, particularly our joint bones and the bones of the spinal column, rebuild and repair themselves as they should. Without exercise, they tend to become thin and porous-a condition known as osteoporosis.

When we do not exercise, fat displaces muscle, muscles become smaller and weaker-a process known as atrophy, and we gain weight more easily because even at rest muscles burn more calories than does fat. Added weight puts added stress on our heart and lungs, and on the weight bearing joints of the knees, hips, ankles, and feet.

It becomes more difficult to climb stairs, get out of a chair, and even to walk and to maintain our balance. Weak muscles cannot protect our joints or help to provide needed strength and balance so that we are more prone to falls. Frail bones and weak muscles limit our ability to care for ourselves and our homes, and to enjoy the later years-years that can and should be a time of productivity and enjoyment.

When you exercise, however, you help to reduce fat tissue, while building muscle and bone. Muscle is heavier than fat but takes up half the space, so you can actually reduce your body measurements without losing weight. Strong muscles help to protect your joints and spinal column, improve your posture and balance, increase your mobility, and reduce the likelihood of falls and other accidents, and give you a younger body image.

1.2 An Ounce of Prevention

When it comes to our health and fitness this is sage advice indeed. But being "out of shape" does not mean that you cannot "get in shape" and this is true not only for people in their 40's, 50's and 60's but people in their 90's as well.

Recent research has found that when it comes to exercise you need a combination of three types-weight training for strength; aerobic exercise for strength and endurance; and calisthenics (stretching, bending, and twisting exercises) for flexibility. Studies have found that violent physical exertion is no more useful to gaining and maintaining fitness than is moderate exercise. What is more, violent physical exertion can result in an increased risk of injury or heart attacks for those who are not in prime physical condition. So start off slow and go slow with your new exercise program.

Walking and other aerobic exercises done at a pace which makes you breathe a little harder and work up a mild sweat for a half hour to one hour three days a week will keep your heart, lungs, and vascular system in good working order and strengthen your bones and muscles.

Exercise intensity for aerobic conditioning is measured by heart rate. A good activity level is 70 percent of your maximum heart rate, which is determined by subtracting your age from 220. Thus the recommended exercise heart rate for a 60-year-old person is 112 beats per minute. People who have not been exercising should begin using 60 percent of their maximum heartbeat as the target heart rate and can ultimately move up to 80 percent when they have reached their maximum fitness level.

Do not attempt a strenuous workout during hot, humid weather and wait until at least two hours after eating before engaging in moderate to heavy exercise. Warning signs of overexertion include an inability to talk, dizziness or disorientation, nausea, or pains in your chest, upper back, left shoulder or arm. If you have any of these symptoms check with your physician as soon as possible.

To avoid excess strain on the heart, and injury to your muscles, warm up for about five minutes before working out, and cool down after exercises. Never abruptly stop exercising, since the sudden stop in motion can cause lightheadness or muscle cramping.

Walking is a good exercise because it can be done at a pace that you can easily set for yourself, it takes no equipment other than a pair of good walking shoes, and it can be done at virtually any time, and on your own. Walking strengthens muscles in the lower body, helps to build new joint bone and tissue, and helps to ward off or slow osteoporosis. Since walking only works the lower half of the body, other aerobic exercises as well as exercises that increase flexibility should be included in your routine. Other good aerobic exercises for weight bearing joints include dancing, tennis, racquetball, basketball, and biking.

Before beginning an exercise program, check with your personal physician and start off slow to avoid overexertion and accidents. And stick with it. Varying the type of physical activity you engage in will help to use all the major muscle groups in your body, and avoid overuse of any one major muscle group. It will also prevent boredom.

Aerobic exercise not only strengthens your bones and muscles and helps to prevent osteoporosis, it also strengthens your heart and helps to maintain your lung capacity. Aerobic exercise slows or prevents the buildup of cholesterol plaque in the veins and arteries (atherosclerosis) and helps to ward off arteriosclerosis or hardening of the arteries by keeping them flexible, thus reducing high blood pressure which plays a major role in heart disease and strokes. Exercise also improves the functioning of the liver, pancreas and other vital organs.

Sustained aerobic exercise can help to control Late Onset, or Type II, diabetes mellitus since it aids in the metabolism of sucrose. What is more, exercise helps to spur the production of human growth hormone which otherwise ceases to be produced after about age fifty. Human growth hormone helps to maintain the size and strength of muscles which diminish as we age.

If you have arthritis and other joint or motion impeding conditions, swimming is an excellent aerobic exercise. It offers many of the benefits of other aerobic exercises without putting undue stress on joints which, because of arthritis or injury, are unable to repair and rebuild themselves in the normal manner. Swimming, however, unlike weight bearing aerobic exercises, does not aid in the rebuilding of bone and therefore is not helpful in preventing or slowing osteoporosis, nor does it appear to be helpful in reducing weight.

Physical exercise not only increases the metabolic rate so that more calories are burned during the activity, but for several hours after you have stopped. What is more, as you improve your muscle tone and enlarge your muscles, they will burn more calories even when you are engaged in sedentary activities.

1.3 Use it or lose it

Not long ago, it was "accepted knowledge" that older people could not increase their muscle strength nor their muscle mass. Now, happily, this myth has been dispelled. In 1989, researchers from Tufts and Harvard Universities undertook a study of older people in their late 80's and 90's. The researchers worked with a group of frail elderly residents at Boston's Hebrew Rehabilitation Center for the Aged. These residents had multiple functional problems, chronic conditions and were very sedentary.

At the beginning of the project, the project participants, whose average age was 90, were tested to determine the heaviest weights that they could lift with their legs. Following this initial test, they began a program of weight training. They did three sets composed of eight weight lifting repetitions each for three days a week. They worked out with weights that were 80 percent of the maximum weight that they could lift.

After two weeks, they were retested and the weights were increased. At the end of six weeks, these frail older people had increased their muscle strength on average by 180 percent. What is more, none of the participants had reached a plateau. As a result of their increased muscle strength, their average walking speed increased 48 percent, two participants no longer needed their canes, and one participant was able to rise from a chair without using the chair arms.

All of the participants resumed their sedentary lifestyles at the end of the program. The researchers then retested them, and found a 32 percent loss in maximum strength after only 4 weeks of detraining. The moral of this story is "If you don't use it, you'll lose it," but the happy ending is that you can regain your fitness and strength at almost any age which will help you to retain or regain your independence, freedom, and add to your good looks.

Weight training is as essential to good physical health in your later years as aerobic exercise is. It strengthens your muscles and bones, and there are indications that it is helpful in lowering cholesterol levels. Weight training also increases the strength of ligaments and tendons so that less stress is placed on your joints. In the past, people with high blood pressure, heart diseases and conditions such as arthritis were warned to avoid using weights. But researchers in the Tufts and Harvard study found that weight training had no adverse effect on blood pressure or heart function and advise that strengthening your muscles, tendons, and ligaments actually helps to ease pressure on the joints.

Weight training can either be with free weights such as barbells and dumbbells, or with specially designed equipment which works various parts of the body. Weight training can be used to increase your muscle strength or your muscle endurance.

If you have not worked with weights before be sure to have a qualified person instruct you in their use and have them set up a program of exercises which includes the specified number of repetitions to be done in each set as you progress toward your goal. Muscle strengthening exercises should be done for at least 20 minutes three times a week.

A program of Calisthenic, Isometric and stretching exercises combined with dance will enable you to develop muscle strength and endurance as well as flexibility and cardio-pulmonary fitness. Joining a class or renting or buying videos made by qualified instructors (not just movie stars) is a good way to get in shape and avoid mishaps. Many dance classes especially those in ballet, modern, and aerobic dance include calisthenic, isometric, and stretching exercises as part of the routine.

Staying physically fit can give you a body that performs and looks like those of persons years younger than your chronological age. At the VA Medical Center in Salt Lake City Utah, physically fit men in their mid-fifties were compared to inactive men in their mid-20's. The results were astounding. Active older men had lower resting heart rates--64 beats per minute versus 85 beats per minute for the younger men, higher oxygen uptake during maximum exercise, and slower heart beats in the first minute after exercise than the men in their 20's who did not keep fit. What is more, the older men weighed an average of 166 pounds compared to 192 pounds for the younger sedentary men.

1.4 Get Moving

Before you begin an exercise program, be prudent and be prepared, check with your physician and make sure that you begin your exercise program "by the book" or with a qualified instructor. In so doing you will gain the maximum benefit from the program and avoid strains, sprains and other mishaps.

Even if you have been exercising on an on-going regular basis, it does not hurt to take a refresher class every so often, since new exercises are added and older, less effective ones are being dropped. And make sure that your instructor is licensed or certified to provide instruction. If no classes are available in your area and you want to start an exercise program on your own, be sure to obtain the latest publications and/or videos available. Some calisthenic and isometric exercises recommended a decade or two ago are no longer considered safe, so it is important to have current information.

Many agencies and organizations including the YM and YWCAs, junior colleges and universities, senior and community centers, adult and continuing education, and health clubs and spa's offer classes in sports, exercise, dance, and weight training that provide instruction that will enable you to gain the maximum result and avoid injuries and mishaps. Source: http://www.aoa.dhhs.gov/aoa/eldractn/

2. Components of Physical Fitness

2.1 Cardio-respiratory (aerobic) endurance

Cardio-respiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel during sustained physical activity (USDHHS, 1996 as adapted from Corbin & Lindsey, 1994). To improve your cardio-respiratory endurance, try activities that keep your heart rate elevated at a safe level for a sustained length of time such as walking, swimming, or bicycling. The activity you choose does not have to be strenuous to improve your cardio-respiratory endurance. Start slowly with an activity you enjoy, and gradually work up to a more intense pace.

2.2 Muscular strength

Muscular strength is the ability of the muscle to exert force during an activity (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). The key to making your muscles stronger is working them against resistance, whether that be from weights or gravity. If you want to gain muscle strength, try exercises such as lifting weights or rapidly taking the stairs.

 
2.3 Muscular endurance

Muscular endurance is the ability of the muscle to continue to perform without fatigue (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). To improve your muscle endurance, try cardio-respiratory activities such as walking, jogging, bicycling, or dancing.

 
2.3 Body composition

Body composition refers to the relative amount of muscle, fat, bone, and other vital parts of the body (USDHHS, 1996 as adapted from Corbin and Lindsey, 1994). A person's total body weight (what you see on the bathroom scale) may not change over time. But the bathroom scale does not assess how much of that body weight is fat and how much is lean mass (muscle, bone, tendons, and ligaments). Body composition is important to consider for health and managing your weight!

 
2.4 Flexibility

Flexibility is the range of motion around a joint (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). Good flexibility in the joints can help prevent injuries through all stages of life. If you want to improve your flexibility, try activities that lengthen the muscles such as swimming or a basic stretching program. References: U.S. Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. 

3. Staying Active When you make staying active part of your daily life, you don't get tired after taking a flight of stairs. You have more energy for weekend get-togethers with family and friends. You're more alert. You do better at school or at work. And you're more sure of yourself. Fitness is about improving endurance, flexibility, and strength through regular physical activity. That even includes things like walking the dog or cleaning the garage. Remember, it's never too late to get more active. Every little bit helps. It doesn't have to be strenuous to be healthy, either. Just start slowly and build gradually. The time to begin is right now. You'll start to notice the difference right away - for both your body and your mind. 3.1 Heart health  Regular physical activity can lower your blood pressure and cholesterol levels and can reduce the risk of illnesses such as Type II diabetes or heart disease. 3.2 Bone support Exercise is a good way to build strong, healthy bones and can help slow the bone loss associated with getting older. 3.3 Sense of well-being Being in good shape can give you more energy, reduce anxiety and depression, improve self-esteem, and help you better manage stress. 3.4 Social life Staying active can be a great way to have fun, make new friends, and spend quality time with family. 3.5 Physical appearance You look better when you're in shape. Staying active helps you tone muscles and maintain a healthy weight - and can even improve your posture. Source: http://www.presidentschallenge.org

4.1. Choose an activity.
Just about any physical activity where you're using large muscle groups and burning energy counts will do. Walking. Playing softball. Taking an aerobics class. You can do this by yourself, or together with friends and family.

 4.2. Get active.
Your goal is to be real physically active at least 3 hours a week, or 30 minutes a day for 5-6 days. The physical activity needs to be moderately vigorous or vigorous, just ordinary physical activity like a relaxed walk does not count. For this course, you need to do that at least for a week. But the idea is that you would continue real active during the rest of your life.

For the President's Award Program, you need to do be real physically active for a total of 6 weeks. You can take up to 8 weeks to complete the President's Award Program.

4.3. Track your activity.
Use the personal activity log below or the one at  http://www.presidentschallenge.org. 

4.4. Optional: Order your award if you follow the President's Award Program.
When you reach your goal, your online activity log at http://www.presidentschallenge.org  will remind you that you've earned an award. You can order it right online or by mail. Then you can continue earning awards in the Active Lifestyle program or move on to the next challenge: the Presidential Champions program.

Programs designed to improve physical fitness take into account frequency (how often), intensity (how hard), and time (how long). Exercise on most days of the week is best. The intensity should be moderate or vigorous. The goal is to spend at least 3 hours weekly exercising.